MEDICARE: MR. RONALD M ERENHOUSE LPC, CAC-D, CEAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC004687	PA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	6660	PA

General Provider Information

NPI Number	:	1396863007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD M ERENHOUSE LPC, CAC-D, CEAP

Provider Business Mailing Address
First Line	:	1600 ARCH ST
Second Line	:	UNIT 1421
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-2028
Country	:	US
Telephone Number	:	267-687-8656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 ARCH ST
Second Line	:	UNIT 1421
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-2028
Country	:	US
Telephone Number	:	267-687-8656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	06/22/2010

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